Evista Drug May Cut Heart Risks

Published 8:00 pm, Monday, February 18, 2002

AP Medical Writer

An osteoporosis drug marketed as an estrogen alternative may significantly lower the risk of heart attacks in postmenopausal women prone to heart disease, a study shows.

Moreover, the drug, called raloxifene and sold under the brand name Evista, does not raise the short-term, one-year risk of heart attacks in such women _ a danger seen in some studies of estrogen supplements.

The drug had no effect on the risk of heart trouble in healthy women, according to the study, which was funded by Evista manufacturer Eli Lilly and Co. Doctors and the company said it would be premature to use the drug to prevent heart problems.

Studies suggesting heart disease patients could face an increased risk of heart attacks in the first year of taking estrogen supplements have confounded patients and doctors, who for years have relied on research suggesting the supplements could help protect the heart.

The studies have heightened the dilemma millions of women face about whether to take menopause hormones, which can relieve symptoms such as hot flashes and protect bones but also have been linked to breast cancer when used for many years.

Company-funded research has suggested Evista reduces the risk of breast cancer and lowers bad cholesterol, but it also has been linked to blood clots and does not relieve symptoms of menopause.

Dr. Elizabeth Barrett-Connor of the University at California at San Diego led the new study, published in Wednesday's Journal of the American Medical Association.

In the study, high-risk women who took raloxifene for four years were 40 percent less likely than women who took dummy pills to have heart attacks or other cardiovascular "events," such as strokes or chest pain. Women were considered high-risk if they had previous heart trouble or had a combination of risk factors such as diabetes and high blood pressure.

The findings come from a re-analysis of a study of 7,705 women that showed raloxifene reduced the risk of spinal fractures. The original study was not designed to test raloxifene's effects on heart disease.

"It's reassuring that raloxifene may not cause an early increased risk of cardiovascular events as has been seen with conventional estrogen, but it's certainly premature to interpret this as suggesting that raloxifene prevents" heart problems, said Dr. JoAnn E. Manson, chief of preventive medicine at Harvard University's Brigham and Women's Hospital.

During the study, there were relatively few heart attacks and other serious cardiovascular problems among high-risk women _ 28 each in women on low and high doses of raloxifene and 41 in the placebo group. Thus, the researchers said, it is possible that the lower risk was a statistical fluke.

Dr. Leo Plouffe, Lilly's U.S. director of women's health and reproductive medicine, called the results promising but said until more research is done, "the reason right now the drug should be used is for women at risk for osteoporosis or with osteoporosis."